NHS needs better regulation not more inspection

The NHS needs more effective and intelligent regulation, rather than “a simplistic race for more inspection”, NHS Confederation chief executive Mike Farrar (pictured) has told the Care Quality Commission inquiry.

Mr Farrar warned in his oral evidence to the House of Commons Public Select Committee inquiry into the CQC that although inspections have a vital role, they reflect “only a limited snapshot” of the care that an organisation is providing. He said the regulator should adjust its approach according to whether it is inspecting a GP surgery, a care home or an NHS trust.

He told the inquiry: “We want an effective and intelligent regulator that focuses its attention where it is most needed,” and went on: “It is clear the regulator needs to do more to earn confidence. Our members are telling us that the CQC is not always proportionate in its approach and its model of regulation is too generic. We hear inspectors can be inconsistent, processes bureaucratic and guidance inadequate.”

But he cautioned against major structural reform of regulation. “History suggests we have had too much of that already,” he said.

He said the CQC should make its priorities to:

focus attention on greatest risks to patients and patient safety

give people certainty about what the regulator is looking for

run efficient, proportionate and consistent processes

develop a well-informed workforce that understands the services regulated

deliver value for money as trusts are concerned by rising costs

ensure the public are clear about what it can, and cannot, do.

Mr Farrar said: “Inspections have a crucially important role … But, by their very nature, inspections only provide a limited snapshot in time of the quality of care being provided in an organisation [and are] only one piece of the jigsaw. A simplistic race for more and more will not necessarily deliver safer care for patients.

“The regulator needs a variety of tools, coupled with a proportionate risk-based approach. It needs to vary its approach in recognition that there is a world of difference between assessing care in a GP surgery, a dental practice, a care home, and indeed the large variety of work that NHS trusts carry out.”